MEDICARE: RESTORATIVE SOLUTIONS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1316900814
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESTORATIVE SOLUTIONS

Provider Business Mailing Address
First Line	:	2027 GRAND CANAL BLVD
Second Line	:	SUITE 31
City	:	STOCKTON
State	:	CA
Zip	:	95207-6650
Country	:	US
Telephone Number	:	209-477-8327
Fax Number	:	209-477-9470

Provider Business Practice Location Address
First Line	:	2027 GRAND CANAL BLVD
Second Line	:	SUITE 31
City	:	STOCKTON
State	:	CA
Zip	:	95207-6650
Country	:	US
Telephone Number	:	209-477-8327
Fax Number	:	209-477-9470

Authorized Official
Title or Position	:	CEO
Name	:	MR. RONDY MICHAEL SCIPPIO SR.
Credential	:
Telephone Number	:	209-477-8327

Provider Enumeration Date	:	04/07/2006
Last Update Date	:	08/22/2020

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Directions to “RESTORATIVE SOLUTIONS ” Practice Location

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